Abstract Background Iodine plays an important role in pregnancy. How to maintain adequate iodine intake amongst pregnant women in each trimester of pregnancy to prevent adverse birth outcomes in central China is a challenge for clinical practice. Methods 870 pregnant women and their infants were enrolled in the study. Urinary iodine concentration (UIC) was measured using an inductively coupled plasma mass spectrometry (ICP-MS). Maternal and newborn information were obtained during follow-up. Multinomial logistic regression models were established. Results Median UIC of pregnant women was 172 ± 135 μg/L which is currently considered to be sufficient. Multivitamin supplements containing iodine, iodized salt intake and frequent milk intake were significantly associated with higher UIC. Multivariate logistic regression analysis showed that multivitamin supplements containing iodine and milk consumption were risk factors for more than adequate iodine (UIC ≥ 250 μg/L). Iodine-rich diet was significantly related to heavier birthweight, larger head circumference and longer femur length of the newborns while more than adequate iodine intake (UIC ≥ 250 μg/L) was a risk factor for macrosomia. Logistic regression models based on potential risk factors involving iodine containing supplements and iodine-rich diet were established to predict and screen pregnant women with high risk of more than adequate iodine intake among local pregnant women in different trimesters and guide them to supplement iodine reasonably to prevent the risk. Conclusions Multivitamin supplements containing iodine and milk consumption were risk factors for maternal UIC ≥ 250 μg/L which was a risk factor for macrosomia. Iodine monitoring models were established to provide guidance for pregnant women to reduce the risk of more than adequate iodine intake, thereby contributing to reduce the risk of having a macrosomia.
Abstract Background The prevalence of vitamin D deficiency and insufficiency is extremely high in pregnant women worldwide. However, the association between single nucleotide polymorphisms (SNPs) in vitamin D metabolic pathway genes and 25‐hydroxyvitamin D (25(OH)D) concentration among Chinese pregnant women is seldom reported. The risk of adverse neonatal outcomes due to maternal vitamin D deficiency has not been well investigated. Methods A total of 815 pregnant women and 407 infants were enrolled in this study. Serum 25(OH)D concentration was detected. DNA was extracted from the maternal blood for genotyping genetic SNPs in vitamin D pathway. An XGBoost model was established based on SNPs combined with external variables. Results Mean serum 25(OH)D level was 15.67 ± 7.98 ng/mL among the pregnant women. Seventy‐five percent of pregnant women had 25(OH)D deficiency in China. SNPs of GC (rs17467825, rs4588, rs2282679, rs2298850, and rs1155563) were significantly associated with maternal 25(OH)D concentration. The influence of variants of rs17467825, rs4588, rs2282679, and rs2298850 on maternal 25(OH)D might be modified by vitamin D supplementation and sunshine exposure. An XGBoost model was established for monitoring 25(OH)D status in pregnant women and provided clinical advice to reduce the risk of 25(OH)D deficiency. Mothers with 25(OH)D deficiency hinted a risk for macrosomia. Conclusion A high prevalence of vitamin D deficiency in China has been confirmed. A clinical model was established to guide pregnant women to supplement vitamin D according to genotype. Furthermore, we suggest the effect of maternal vitamin D status on the risk of macrosomia.
Our aim was to investigate the prognostic factors of pregnancy related acute kidney injury (PR-AKI), establish the prognosis prediction model and evaluate predictability with the model.Serum creatinine (SCr), placental growth factor (PLGF), endothelin-1 (ET-1), urinary kidney injury molecule-1 (KIM-1), and β2-microglobulin (β2-MG) levels in 122 patients with PR-AKI were measured at 1 month, 3 months, 6 months, and 1 year after delivery and the logistic backward stepwise regression method was used to screen the factors associated with the prognosis, establish the model to predict the prognosis of patients 1 year after delivery, and evaluate predictability with the model.1) At 1 month, 3 months, 6 months, and 1 year after delivery, SCr was not significantly different in the poor prognosis group (P˃0.05); ET-1, KIM-1 and β2-MG were decreased significantly, and PLGF was significantly increased (P˂0.05); all testing indicators in the good prognosis group were significantly different and returned to normal within 1 year (P˂0.05). By comparing the two groups, there were no significant differences in SCr, PLGF and β2-MG levels at 1 month after delivery (P˃0.05), while there were significant differences in the remaining testing indicators at each time point (P˂0.05). 2) Logistic backward stepwise regression analysis showed that SCr, KIM-1, ET-1, and time were related to the prognosis of patients with PR-AKI, and the above screening indicators were used to fit the model Logit.The logistic regression model fitting-effect was good, its accuracy of predicting renal injury prognosis was high. SCr, KIM-1, and ET-1 can be used for PR-AKI screening and are important for monitoring the disease condition of patients, intervention, and evaluation of prognosis.
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